Propensity-matching of patients from a large database of CT calcium score images reveals a distinct coronary calcification profile in diabetes mellitus

Prerna Singh; Ammar Hoori; Joshua Freeze; Sadeer Al-Kindi; Sanjay Rajagopalan; David L. Wilson

doi:10.1117/12.3005974

2 April 2024 Propensity-matching of patients from a large database of CT calcium score images reveals a distinct coronary calcification profile in diabetes mellitus

Prerna Singh, Ammar Hoori, Joshua Freeze, Sadeer Al-Kindi, Sanjay Rajagopalan, David L. Wilson

Author Affiliations +

Proceedings Volume 12930, Medical Imaging 2024: Clinical and Biomedical Imaging; 129300F (2024) https://doi.org/10.1117/12.3005974
Event: SPIE Medical Imaging, 2024, San Diego, California, United States

Abstract

Patients with Diabetes Mellitus (DM) have an increased risk of Major Adverse Cardiac Events (MACE), commonly stratified via the Agatston score. In this study, we investigated Coronary Artery Calcification (CAC) patterns in patients with DM, to understand its impact on cardiovascular health. By individually segmenting CACs from over 25,000 Computed Tomography Calcium Score (CTCS) images and integrating clinical data, we created a propensity-matched cohort to isolate the effect of DM on calcification patterns by controlling for confounding variables such as age, gender, BMI, and medication use. We hand-crafted a novel set of 67 calcium-omics imaging features capturing the distribution, shape, density, and more of individual CACs and aggregated CAC features per artery. Diabetic patients, compared to nondiabetic, exhibited significantly higher Agatston (p-value: ⪅0.0005) and larger volume scores (p-value: 0.0018). Interestingly, diabetic patients had fewer calcified arteries (p-value: ⪅0005) and lower density calcifications than nondiabetic patients. Although previous studies have reported that DM leads to higher Agatston scores, to our knowledge, no studies have reported that this is driven by high-volume, low-density calcifications present in only one to two arteries. These findings suggest a distinct phenotype indicative of the continuing development of new lesions in affected arteries, possibly contributing to the increased incidence of MACE. This exploration of diabetes-related CAC patterns enhanced our understanding of the mechanisms of atherosclerotic cardiovascular disease in DM, emphasizing the need for targeted interventions and redefined cardiovascular risk models for this vulnerable population.

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(2024) Published by SPIE. Downloading of the abstract is permitted for personal use only.

Citation Download Citation

Prerna Singh, Ammar Hoori, Joshua Freeze, Sadeer Al-Kindi, Sanjay Rajagopalan, and David L. Wilson "Propensity-matching of patients from a large database of CT calcium score images reveals a distinct coronary calcification profile in diabetes mellitus", Proc. SPIE 12930, Medical Imaging 2024: Clinical and Biomedical Imaging, 129300F (2 April 2024); https://doi.org/10.1117/12.3005974

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